| NPI | 1073165148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012088) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: NC 5012088) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177827) | |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2023-03-28 |